We carried out an inspection of Le Moors on 15 and 16 May 2017. We gave the service 48 hours’ notice of the inspection because it is a small service and we wanted to make sure the people living there and the manager would be in.

Le Moors provides accommodation and personal care for up to eight people, including people with a learning disability and people living with dementia. At the time of our inspection there were eight people living at the service.

Bedrooms at the service are located over two floors and a lift is available. There is an open plan lounge and dining room on the ground floor. Bedrooms do not have ensuite facilities. However, there are suitably equipped toilet and bathroom facilities on both floors.

At the time of our inspection the service had a registered manager who had been in post since 2012. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During a previous inspection on 16 and 17 December 2015, we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to medicines management, the safety of the premises, assessing and monitoring the quality of the service and supporting people to be involved in the community. We carried out a follow up inspection on 1 June 2016 and found that the provider had made the improvements necessary to meet legal requirements.

During this inspection we found that the provider was meeting all CQC regulations.

Relatives and staff told us they felt the people living at Le Moors received safe care and staffing levels were appropriate to meet people’s needs.

We saw evidence that staff had been recruited safely and the staff we spoke with had a good understanding of how to safeguard vulnerable adults from abuse and what action to take if they suspected abuse was taking place.

There were appropriate policies and procedures in place for managing medicines safely and relatives were happy with the way people’s medicines were managed. People were supported with their healthcare needs and were referred appropriately to a variety of healthcare services. Local healthcare professionals gave us positive feedback about the service and told us they did not have any concerns.

Staff told us they received an appropriate induction, effective training and regular supervision. They told us communication between staff and with people living at the service and their relatives was good.

We observed that people’s needs were responded to in a timely manner and saw evidence that their needs were reviewed regularly. We saw staff treating people with patience, kindness and affection. One person living at the service told us they liked the staff there. Relatives told us the staff who supported their family members were caring.

The service had taken appropriate action where people lacked the capacity to make decisions about their care. Relatives told us they were involved in decisions about their family member’s care. They felt that staff respected people’s privacy and dignity and encouraged them to be independent.

Relatives were happy with the food provided at the home and we observed people being supported appropriately with their meals. Risks relating to people’s nutrition and hydration were assessed and managed appropriately.

A variety of activities were available at the service and people were encouraged to take part. However, the frequency of people being supported to visit the community and the variety of community trips available needed to be improved.

We saw evidence that the manager requested feedback about the service from people and their relatives. Questionnaires received from relatives demonstrated a high level of satisfaction with

We carried out an unannounced inspection of Le Moors on 16 and 17 December 2015. Breaches of legal requirements were found. After the inspection, the provider sent us an action plan detailing what action they would take to meet legal requirements in relation to the breaches of Regulation 10, 12, 15 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider told us that all actions would be completed by 31 March 2016.

We undertook this focused inspection on 1 June 2016 to check whether the provider had followed their action plan and made the improvements necessary to meet legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Le Moors on our website at www.cqc.org.uk.

Le Moors provides accommodation and personal care for up to eight people, including people with a learning disability and people living with dementia. At the time of our inspection there were seven people living at the service.

At the home bedrooms are located over two floors and a passenger lift is available. There is an open plan lounge and dining room on the ground floor. Bedrooms do not have ensuite facilities. However, there are suitably equipped toilet and bathroom facilities on both floors.

At the time of our inspection the service had a registered manager who had been in post since 2012. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At this inspection we found that the provider had followed their action plan and legal requirements were being met.

People’s medicines were being managed properly and safely and the home environment was safe.

The registered manager had submitted appropriate applications to the relevant authority, where people needed to be deprived of their liberty to keep them safe.

Regular audits were being completed by the registered manager and the provider in relation to many areas of the service. These were effective in ensuring that appropriate levels of care and safety were achieved and maintained.

Communication at the service had improved and the handover of information between staff during shift changes was more effective. This meant that staff were able to keep up to date with people’s needs.

People were being supported to go out into the community more often. However, there was a lack of variety in relation to where people were being supported to go.

We saw there was sensitive communication between the staff and people who used the service. Throughout the inspection we saw staff were interacting with people who lived at the home. We found people were not left alone for long periods but were also were given time to spend quietly, if preferred.

We reviewed information about two people's care and found their care needs were being planned for. We found the staff understood people's care needs and how to protect them from risk and harm.

Records we looked at showed people's needs were assessed and care and treatment was planned and delivered in line with the individual care plans.

Suitable arrangements were in place to ensure people were safeguarded against the risks of abuse. However we did find additional arrangements were required to ensure people’s finances were managed effectively.

We saw there were effective recruitment procedures and checks were in place to ensure people’s health and welfare needs were met by staff that were and qualified to do their job.

We found suitable arrangements were in place to deal with and manage any complaints made about the home.

People who were able to tell us about their care at Le Moors told us they were happy living at Le Moors and said it was "alright" and went out on a regular basis. People were satisfied with the service provided. One person told us, "It's very nice here".

We found their rights to privacy; dignity and independence were upheld and respected.

People's care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments and daily care records. This meant people's care could be readily monitored and evaluated.

Staff told us they were supported by the management and had regular supervision and appraisals as well as receiving updated training.

The environment and safety and suitability of the premises was safe and suitable for the people living at Le Moors.

The service had implemented regular audits and risk assessments as well as consulted with service users and family members to monitor the quality of service provision.

We carried out an inspection of Le Moors on 16 and 17 December 2015. The first day of the inspection was unannounced.

Le Moors provides accommodation and personal care for up to eight people, including people with a learning disability and people living with dementia. At the time of our inspection there were seven people living at the service.

Bedrooms are located over two floors and a lift is available. There is an open plan lounge and dining room on the ground floor. Bedrooms do not have ensuite facilities. However, there are suitably equipped toilet and bathroom facilities on both floors.

At the time of our inspection there was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection in April 2015, we asked the provider to make improvements to staffing levels, the management of risks, medicines management, care planning, supporting people to access the community and quality assurance processes. The provider sent us an action plan detailing the improvements to be made and advised that all actions would be completed by 31 October 2015. During this inspection we found that further improvements were needed in some areas.

During this inspection we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to medicines management, the safety of the premises, assessing and monitoring the quality of the service and supporting people to be involved in the community. You can see what action we told the provider to take at the back of the full version of the report.

The relatives and staff we spoke with told us they felt the people living at Le Moors were kept safe.

We saw evidence that staff had been recruited safely and the staff we spoke with had a good understanding of how to safeguard vulnerable adults from abuse and what action to take if they suspected abuse was taking place.

We found that staffing levels at night were not sufficient to ensure that people’s needs were met. However, during our inspection arrangements were made for an additional member of staff to be on duty at night.

There were appropriate policies and procedures in place for managing medicines and staff had received appropriate training in medicines management. However, the training received was not always translated into practice, as staff did not always manage medicines in line with national guidance. Medicines documentation was not always completed appropriately and there were not always clear instructions for how medicines should be administered. This meant that people may not have received their medicines safely.

We found that some areas of the home were not safe. Nails were exposed in the upstairs bathroom and toilet and the door to the cellar was not always securely locked. This could have put people living at the service at risk of accidents or injuries.

The relatives we spoke with were happy with the care provided at Le Moors. One relative told us, “We’re very happy with the care. Our relative is very well cared for”.

We found that staff received an appropriate induction, regular supervision and could access training if they needed it. They told us communication between staff and with people living at the service and their relatives was good.

People were supported by staff to make decisions wherever possible. Where people lacked the mental capacity to make decisions about their care, decisions were made in their best interests in consultation with their relatives.

We found that people were supported appropriately with their nutritional and healthcare needs.

A local district nurse was happy with the care being provided at the service. However, a community nurse from the local learning disability team told us that information about changes in people’s needs was not always communicated between staff. This meant that staff may not have been aware of people’s needs and how to meet them.

The people we spoke with told us that staff at the service were caring and we saw staff treating people with kindness and respect.

Relatives told us staff respected people’s privacy and dignity and encouraged them to be independent and we saw evidence of this.

We observed that people’s needs were responded to in a timely manner and saw evidence that their needs were reviewed regularly.

A variety of activities were available at the service and people were encouraged to take part. However, people were not supported to be involved in the community regularly. We found that people were supported to leave the home less than once each month. This meant that people’s choices were being restricted and their social needs were not being met.

We saw evidence that the manager requested feedback about the service from people and their relatives. Questionnaires received from relatives demonstrated a high level of satisfaction with the service.

Relatives told us they felt the service was well managed and they felt able to raise any concerns.

We saw that the service had a clear statement of purpose which focused on the importance of people’s privacy, dignity and independence.

The staff and the registered manager communicated with people, their relatives and each other in a polite and respectful manner.

The registered manager and staff had a caring and compassionate approach towards the people living at the service. Relatives told us they were approachable.

We saw evidence that a variety of audits were being completed. However, the audits being completed were not effective in ensuring that appropriate levels of safety at the home were being achieved and maintained. They had not identified the issues we found during our inspection.